A.C. Camargo Cancer Center, São Paulo, Brazil
Alexandre Andre B. A. Da Costa , Adriana Regina Goncalves Ribeiro , Henrique Mantoan , Carlos Stecca , Elizabeth Santana dos Santos , Joao Paulo Lima , Audrey Oliveira , Deborah Porto Cotrim , Larissa Von Grapp , Victor Aurelio Ramos Sousa , Joyce Maria L. Maia , Andrea Paiva Guimaraes , Glauco Baiocchi
Background: Neoadjuvant chemotherapy (NCT) is an option to treat ovarian cancer patients with bulky peritoneal disease who are not good candidates to complete primary debulking surgery. The best timing of NCT pause before surgery and restart after surgery is not clearly established. A recent paper suggested a longer interval between last NCT and first adjuvant chemotherapy (ACT) could have a negative prognostic impact. In this paper we evaluated the optimal timing between last NCT and surgery and between surgery and first ACT. Methods: We retrospectively evaluated ovarian cancer patients treated with NCT and debulking surgery at A.C.Camargo Cancer Center – Brazil from 2007 to 2017. At our institution, primary debulking surgery is the standard care, and patients are treated with NCT if there is a high risk for incomplete debulking in primary surgery or the patient have a poor performance status. Interval between last NCT and surgery and between surgery and first ACT were calculated and other clinical characteristics and outcomes collected. We used a cut-off finder method that optimizes the cut-off according to the statistical significance of the hazard ratio for overall survival (OS). Results: There were 122 patients treated with NCT and with available clinical data. Median age was 62.2 years old, 87.7% of patients had high grade serous carcinoma, 6.6% had ECOG performance status of 2 or worse, 78.8% had FIGO stage IIIC disease and 19.7% had FIGO stage IV disease. Interval debulking surgery with residual disease smaller than 1cm was achieved in 73.0%. Median interval between last NCT and surgery was 55.0 days and between surgery and first ACT was 49 days. With a median follow-up of 46.6 months median OS was 48.3 months. Interval between last NCT and surgery longer than 55 to 60 days had a negative impact on survival, and interval between surgery and first ACT between 50 and 60 day had a negative impact on survival. Other cut-off values for this interval resulted in no significant impact on OS. Number of NCT cycles had no impact on OS. Conclusions: Interval between NCT and surgery and between surgery and ACT should be no longer than 60 days.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2021 ASCO Annual Meeting
First Author: Shinichi Tate
2023 ASCO Quality Care Symposium
First Author: Yongmei Huang
2023 ASCO Gastrointestinal Cancers Symposium
First Author: Hyung-Don Kim
2019 ASCO Annual Meeting
First Author: Ashwin K Rajgopal